Sarcoma Clinical Trial
Official title:
High-Dose Doxorubicin and Ifosfamide Followed by Melphalan and Cisplatin for Patients With High-Risk and Recurrent Sarcoma
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining more than one drug and combining chemotherapy with
peripheral stem cell transplantation may allow the doctor to give higher doses of
chemotherapy drugs and kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of high-dose combination chemotherapy and
peripheral stem cell transplantation in treating patients who have advanced or recurrent
sarcoma.
OBJECTIVES: I. Determine the feasibility of sequential high-dose chemotherapy with
ifosfamide and doxorubicin followed by melphalan and cisplatin, each followed by autologous
peripheral blood stem cell support, in patients with high-risk or advanced sarcomas. II.
Determine the toxic effects of this regimen in these patients. III. Determine response rate
and disease-free and overall survival in these patients treated with this regimen.
OUTLINE: Beginning at least 4 weeks prior to the start of chemotherapy, patients receive
filgrastim (G-CSF) subcutaneously daily until the completion of peripheral blood stem cell
(PBSC) harvesting. Beginning 5 days after the start of G-CSF, PBSCs are collected over
several days. Patients who do not mobilize sufficient cells undergo bone marrow harvest.
Regimen A: Patients receive high-dose ifosfamide IV and doxorubicin IV continuously over 96
hours on days -8 to -4. 12.5% of PBSCs or bone marrow are reinfused on day -2 and 37.5% are
reinfused on day 0. Patients receive G-CSF IV beginning on day 0 and continuing until blood
counts recover. Regimen B: Beginning at least 4 weeks after day 1 of Regimen A, patients
receive high-dose melphalan IV followed immediately by cisplatin IV on days -11 and -4.
Patients receive G-CSF IV on days -10 to -6. 12.5% of PBSCs or bone marrow are reinfused on
day -3 and the remaining 37.5% are reinfused on day 0. Patients receive G-CSF IV beginning
on day 0 and continuing until blood counts recover. Patients are followed monthly for 1
year, every 3 months for 1 year, and then as needed for 3 years.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study within 3 years.
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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